Intraoperative Retrobulbar Hemorrhage following Subtenon Anaesthesia and Valsalva Manoeuver: A Case Report
General Ophthalmology
Abstract
Introduction: An advantage of sub-tenon’s over retrobulbar injection is the lower risk of retrobulbar hemorrhage (RBH) associated with the former. We present a case of RBH noticed intraoperatively during trabeculectomy surgery following subtenon anaesthesia and Valsalva manoeuvre.
Case Report: A 51 year old woman presented with poor vision OS first noticed two years prior to presentation. She was not a known hypertensive and had no prior history of bleeding disorders. Examination at presentation showed a visual acuity of 6/6-2 OD and HM OS, RAPD OS, open angles on gonioscopy OU, CDR 0.5 OD and 1.0 OS. Based on a diagnosis of Open-angle glaucoma and suboptimal IOP control on medications, she was scheduled bilateral trabeculectomy. Preoperatively she had O’Brien facial block and then sub- tenon’s injection just prior to commencement of right trabeculectomy.
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